$531.01
Both codes concern closed treatment of a calcaneal fracture. Choose 28400 when no manipulation is performed; choose 28405 when treatment includes manipulation.
On this page
CMS RVU26D · Effective 2026-10-01
28400 Fracture treatment Medicare reimbursement rates in Hawaii
Reports closed treatment of a calcaneal fracture managed without manipulation, such as immobilization when the fracture does not require reduction. Compare 28400 office and facility rates across CMS payment localities in Hawaii.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 28400 in Hawaii?
Hawaii has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$291.18
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
One mapped payment locality.
Facility setting
$249.03
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Fracture care
About 28400: Closed calcaneal fracture treatment without manipulation
Reports closed treatment of a calcaneal fracture managed without manipulation, such as immobilization when the fracture does not require reduction.
This service covers nonoperative treatment of a heel bone fracture when the treating clinician manages the fracture without manipulating it to change its alignment. An orthopedic surgeon or podiatrist may provide care in an office, emergency department, or outpatient setting. Treatment commonly includes immobilization in a cast or boot and planned clinical and imaging follow-up. The key distinction is the treatment performed, not simply whether the fracture is displaced on imaging.
Report the code when the documented plan and service support closed fracture care without manipulation. The record should identify the calcaneal fracture and show that manipulation or fixation was not performed. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are paid at 50%. For bilateral treatment with modifier 50, payment is 150%. Medicare does not pay an assistant at surgery for this code; co-surgeons and team surgery are not permitted.
CMS billing rules for 28400
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU2.25 · 28%
- Practice expense (office) RVU5.50 · 68%
- Malpractice RVU0.37 · 5%
1.7K
Medicare services in 2024 · #2572 by national volume
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
28400 compared with similar codes
Office rates for Hawaii, from the same CMS release.
No office rate
This code represents treatment without manipulation or fixation. Code 28406 involves percutaneous skeletal fixation with manipulation.
No office rate
Code 28400 describes nonoperative closed care without manipulation. Code 28415 is for open treatment of the calcaneal fracture.
$285.52
Code 28400 is for a calcaneal fracture; 28430 concerns closed treatment without manipulation of a talus fracture.
Compare 28400 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Hawaii, Guam →
Office / nonfacility
$291.18
Facility
$249.03
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 28400 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
3,198
- Code
- 28400
- Physician work
- 2.25
- Practice expense
- 5.50
- Malpractice
- 0.37
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.25 | × 1.000 | 2.2500 |
| Practice expense | 5.50 | × 1.137 | 6.2535 |
| Malpractice | 0.37 | × 0.579 | 0.2142 |
| Total RVUs | 8.7177 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Hawaii, Guam$291.18
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.25 | 1 |
| Practice expense | 5.5 | 1.137 |
| Malpractice | 0.37 | 0.579 |
(2.25 × 1 + 5.5 × 1.137 + 0.37 × 0.579) × $33.4009 = $291.18
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.25 | 1 |
| Practice expense | 4.39 | 1.137 |
| Malpractice | 0.37 | 0.579 |
(2.25 × 1 + 4.39 × 1.137 + 0.37 × 0.579) × $33.4009 = $249.03
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
28400 billing questions
How is this different from 28405?
Use 28400 when the calcaneal fracture is treated without manipulation. Code 28405 describes closed treatment that includes manipulation.
When would 28406 be more appropriate?
Code 28406 is for percutaneous skeletal fixation of a calcaneal fracture with manipulation. It is not the code for immobilization alone without manipulation or fixation.
Can casting or boot application be billed separately?
Routine immobilization is part of the fracture treatment service. Do not separately report routine cast or boot application for the same fracture care.
What documentation supports reporting 28400?
Document the calcaneal fracture, the treatment plan, and that the fracture was managed without manipulation. The record should support that fracture care was provided, rather than imaging or an evaluation alone.
How is bilateral treatment reported?
For bilateral calcaneal fracture treatment, report modifier 50; CMS pays the bilateral procedure at 150%.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
3,19528344,,Repair extra toe(s),A,,4.29,7.62,,3.24,,0.37,12.28,7.90,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,19628345,,Repair webbed toe(s),A,,5.94,8.62,,3.71,,0.49,15.05,10.14,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,19728360,,Reconstruct cleft foot,A,,14.55,13.05,NA,13.05,,3.09,30.69,30.69,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,19828400,,Cltx calcaneal fx w/o mnpj,A,,2.25,5.50,,4.39,,0.37,8.12,7.01,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,19928405,,Cltx calcaneal fx w/mnpj,A,,4.62,9.41,,6.35,,1.00,15.03,11.97,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,20028406,,Prq skel fix clcnl fx w/mnpj,A,,6.40,8.84,NA,8.84,,1.21,16.45,16.45,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,20128415,,Optx calcaneal fracture,A,,15.79,12.90,NA,12.90,,2.71,31.40,31.40,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503
4410212,GA,01,ATLANTA,1.003,1.016,1.201
4510212,GA,99,REST OF GEORGIA,1.000,0.892,1.192
4601212,HI,01,"HAWAII, GUAM",1.000,1.137,0.579
4702202,ID,00,IDAHO,1.000,0.920,0.473
4806102,IL,16,CHICAGO,1.007,1.005,2.295
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014